Figure 2: IR Training Pathways in the United States Source: SIR-RFS Past, Current, and Future IR Training Models


YEAR PGY–1 PGY–2


PGY–3 PGY–4


PGY–5 2 years of IR training PGY–6 PGY–7 N/A 1 year of IR fellowship training N/A Total years of training 66 7


requiring negotiations with hospital managers rather than an institutional ‘given’. IR residents and Fellows participate fully in this clinical practice.


Training in the United States In the United States, IR was recognized as a primary medical specialty by the American Board of Medical Specialties in 2012, and in 2015 the integrated IR residency program was approved by the American College of Graduate Medical Education. With the new integrated IR model, trainees have three pathways to become an IR (Figure 2). The most common pathway would allow medical students to match directly into a 6-year integrated IR residency program, consisting of the traditional intern year followed by 5 years of integrated IR/ DR training. For medical students who are unsure about pursuing IR directly out of medical school, two additional pathways include:


1. The 5-year early-specialization (ESIR) program, which allows residents in diagnostic radiology to focus the last year of DR training on IR skills before matching into a one-year independent IR residency.


20 IRQ | SPRING 2022


2. Completing a 2-year independent IR residency after finishing the 5-year DR residency.


Like the UK training model, these pathways allow for flexibility, as residents who match into DR residency still have the option to pursue IR if desired, while integrated IR residents can switch into the DR residency program should they decide that IR is not for them.


The creation of the integrated IR residency program was aimed to produce IR graduates who are strong both clinically and procedurally, being able to uphold the clinical practice model of IR going forward. Residents are expected to have regular IR rotations throughout residency that includes outpatient IR clinic to provide experience in longitudinal patient care, as well as inpatient rotations that stress comprehensive medical management and vascular medicine such as ICU and vascular surgery. After completion of IR/ DR residency, trainees will need to pass both the written and the oral portions of the ABR certification exam to receive the IR/DR Certificate.


2 years of IR residency training


Integrated IR Residency


Traditional Pathway Offered until June 30, 2020


Independent IR Residency


Offered starting July 1, 2020


Independent IR


Residency with ESIR Offered starting July 1, 2020


1 year ACGME approved non-radiology clinical training (internship)


Diagnostic radiology training +


3 IR rotations


Diagnostic radiology residency


Diagnostic radiology residency


Diagnostic radiology residency with ESIR; Program requires complection of 12 IR or IR-related


rotations and at least 500 image-guided


procedures within the IR domain.


1 year of IR residency training


N/A 6


Conclusion In each country, the curriculum is designed to prepare future IRs for clinical and procedural work, with many training programs allowing flexibility to choose between IR and DR. Given the close collaboration between international IRs, understanding the similarities and differences in training can increase the sharing of ideas, educational opportunities and progression of the specialty on a global front.


References


1. Interventional radiology curriculum. The Royal College of Radiologists. rcr.ac.uk/clinical- radiology/specialty-training/curriculum/ interventional-radiology-curriculum


2. CIRSE European Trainee Forum Subcommittee. Status of vascular and interventional radiology training in Europe. Cardiovascular and Interventional Radiological Society of Europe. April 2020. cirse.org/wp-content/uploads/2020/05/ ETF_survey_brochure_2020_web.pdf


3. Makris G C, Burrows V, Lyall F, Moore A, Hamady M S. Vascular and interventional radiology training; International perspectives and challenges. Cardiovasc Intervent Radiol (2021)44:462–472


4. CIRSE European Trainee Forum Subcommittee. Medical students’ perspectives on IR. March 2021.


5. Career Pathway. irjuniors.com.


6. SIR-RFS. Past, current, and future IR training models. rfs.sirweb.org


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